Objective. To investigate the prevalence of oral cleft live births in the Netherlands, we analyzed time-trends in the Netherlands and Northern Netherlands (NNL) over the period 1997-2007 and stratified these trends by cleft category (cleft lip/alveolus ± cleft palate: CL±P; cleft palate only: CP). Methods. Patients born alive with oral clefts in the Netherlands during 1997-2007 were included from three Dutch registries on congenital anomalies/oral clefts. The estimated annual percentage change (EAPC) in prevalence was calculated using Poisson regression. Results. The overall prevalence of oral clefts per 10,000 live births was 16.6 in the Netherlands and 21.4 in NNL. During 1997-2007, the live-birth prevalence of oral clefts in the Netherlands decreased significandy (EAPC -2.0%; 95% CI: -3.0% to -0.90%), as did the CL±P prevalence (EAPC -2.1%; 95% CI: -3.4% to -0.80%), while no significant trend in CP was found. The rates of the region NNL showed no significant trends. Discussion. The national decrease in prevalence may be explained by two hypotheses: 1) greater prenatal detection of congenital anomalies including oral clefts has led to more pregnancy terminations; and 2) increased periconceptional folic acid use has reduced the risk of oral clefts. Both hypotheses would mainly apply to the category CL±P, since, unlike CP, this category can be detected prenatally by 2D ultrasound and develops during the period recommended for folic acid use. Conclusion. Because the CL±P prevalence in the Netherlands decreased, that of all oral clefts decreased. Although the rates in the region NNL were higher, they showed no significant trends.